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Petiot F, Descargues P, Devouassoux-Shisheboran M, You B, Rousset-Jablonski C, Raffin D, Hajri T, Gertych W, Glehen O, Philip CA, Lamblin G, Golfier F, Bolze PA. Retrospective analysis of uterine involvement in low grade serous ovarian carcinoma. Eur J Obstet Gynecol Reprod Biol 2024; 294:191-197. [PMID: 38295707 DOI: 10.1016/j.ejogrb.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVES Low grade serous ovarian carcinoma (LGSOC) accounts for 2.5% of all ovarian carcinoma more affects younger women than high grade serous ovarian carcinoma. Hysterectomy is performed routinely for LGSOC treatment, but fertility sparring surgery (FSS) is feasible for some early stages. Currently, there is no study about uterine involvement in LGSOC. We evaluate uterine involvement in LGSOC patients and aim to identify pre-operative predictive factors. METHODS Retrospective observational study of LGSOC patients treated between January 2000 and May 2022 in the Hospices Civils de Lyon. All cases were viewed, reviewed or approved by an expert pathologist. RESULTS Among 535 serous ovarian carcinomas, 26 were included. Most patients (73 %) had FIGO III disease. Median OS was 115 months and median PFS was 42 months. Uterine involvement was found in 58 % patients who underwent hysterectomy (14/24), serosal involvement was the most frequent type of involvement (n = 13, 54 %). Myometrial involvement was found in 8 patients (33 %) and was associated with serosal involvement (7/8). Among patients with a macroscopic disease-free uterus during exploratory laparoscopy, 31 % had a microscopic serosal involvement. None patient with presumed early stage (FIGO I) were upstaged due to uterine involvement (serosal or myometrial). In patients with stage FIGO IIII, 72 % of uterine involvement were found. Univariate analysis did not show any predictive factor of myometrial involvement. There was no difference on OS nor PFS between patients with or without myometrial involvement. CONCLUSIONS In early stages LGSOC, FSS may be considered for selected patients. In advanced stages, hysterectomy should be performed routinely, since no predictive factor for uterine involvement were identified.
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Affiliation(s)
- Florian Petiot
- Université Lyon 1, CHU Lyon Sud, Department of Gynaecological Surgery and Oncology, Obstetrics, Pierre Bénite, France.
| | - Pierre Descargues
- Université Lyon 1, CHU Lyon Sud, Department of Gynaecological Surgery and Oncology, Obstetrics, Pierre Bénite, France
| | | | - Benoit You
- Université Lyon 1, CHU Lyon Sud, Department of Medical Oncology, Pierre Bénite, France
| | - Christine Rousset-Jablonski
- INSERM U1290 RESearch on HealthcAre PErformance (RESHAPE), Université Lyon 1, CHU Lyon Sud, Department of Gynaecological Surgery and Oncology, Obstetrics, Pierre Bénite, France; Department of Surgical Oncology, Centre Léon Bérard, Lyon, France
| | - Delphine Raffin
- Université Lyon 1, CHU Lyon Sud, Department of Gynaecological Surgery and Oncology, Obstetrics, Pierre Bénite, France
| | - Touria Hajri
- French Trophoblastic Disease Reference Center, CHU Lyon Sud, Pierre Bénite, France
| | - Witold Gertych
- Université Lyon 1, CHU Lyon Sud, Department of Gynaecological Surgery and Oncology, Obstetrics, Pierre Bénite, France
| | - Olivier Glehen
- Université Lyon 1, CHU Lyon Sud, Department of Digestive Surgery, Pierre Bénite, France
| | - Charles-André Philip
- Université Lyon 1, CHU Croix-Rousse, Department of Obstetrics and Gynecology, Lyon, France
| | - Géry Lamblin
- Université Lyon 1, Hôpital Femme Mère Enfant, Department of Obstetrics and Gynecology, Bron, France
| | - François Golfier
- Université Lyon 1, CHU Lyon Sud, Department of Gynaecological Surgery and Oncology, Obstetrics, Pierre Bénite, France
| | - Pierre-Adrien Bolze
- Université Lyon 1, CHU Lyon Sud, Department of Gynaecological Surgery and Oncology, Obstetrics, Pierre Bénite, France
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Gan W, Bian C. The research progress on synchronous endometrial and ovarian carcinoma. Front Oncol 2023; 13:1291602. [PMID: 38144530 PMCID: PMC10748788 DOI: 10.3389/fonc.2023.1291602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Synchronous endometrial and ovarian carcinoma (SEOC) is the most common combination of primary double cancer in the female reproductive system. The etiology and pathogenesis of SEOC remain unclear, and clinically, it is often misdiagnosed as metastatic cancer, affecting the formulation of treatment plans and prognosis for patients. This article provides a review of its epidemiology, pathological and clinical characteristics, risk factors, pathogenesis, diagnosis, treatment, and prognosis.
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Affiliation(s)
- Wenli Gan
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Gynecology and Obstetrics, Affiliated Hospital of Sichuan Nursing Vocational College (The Third People's Hospital of Sichuan Province), Chengdu, Sichuan, China
| | - Ce Bian
- Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, Sichuan, China
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Benoit L, Pajot C, Koual M, Nguyen-Xuan HT, Bentivegna E, Bats AS, Azaïs H. Could uterine conservation be an option in presumed early-stage epithelial ovarian cancer? Arch Gynecol Obstet 2023; 308:953-960. [PMID: 37031304 DOI: 10.1007/s00404-023-07016-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/18/2023] [Indexed: 04/10/2023]
Abstract
PURPOSE In early-stage epithelial ovarian cancer (EOC), patients usually undergo a hysterectomy. However, in fertility sparing surgery (FSS), carefully selected patients could conserve their uterus. The aim of our study was to evaluate the incidence and epidemiologic characteristics associated with uterine involvement in patients with early-stage EOC, outside of FSS. METHODS We conducted a retrospective, monocentric, study from 2003 to 2019 and included all patients with a presumed early-stage EOC (FIGO I) who underwent a hysterectomy. The incidence of uterine involvement, predictive factors of uterine involvement, and the impact of uterine involvement on survival (recurrence-free survival and overall survival) were analyzed. RESULTS Eighty-five patients had an early-stage EOC. Of these, six had an uterine involvement (7%). The populations of patients with or without uterine involvement did not differ except for CA 125 at diagnosis (136 ± 138 versus 356 ± 723, p = 0.04, respectively). No patient or tumor characteristics were predictive of uterine involvement. Uterine involvement was not associated with recurrence-free survival (HR = 1.26, IC95% 0.36-4.4, p = 0.72) or overall survival (HR = 0.7, IC95% 0.1-6.1, p = 0.77). CONCLUSION Due to the small size of our sample, no conclusion can be drawn, yet it could be hypothesized that, for selected patients, a systematic hysterectomy could be discussed, notably in restaging surgery.
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Affiliation(s)
- Louise Benoit
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France.
- Faculté de médecine Paris-Descartes, Université Paris Cité, Paris, France.
- INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saints Pères, Paris, France.
- Gynecologic and Breast Oncologic Surgery Department, European Georges Pompidou Hospital, 20 Rue Leblanc, 75015, Paris, France.
| | - Camille Pajot
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
| | - Meriem Koual
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
- Faculté de médecine Paris-Descartes, Université Paris Cité, Paris, France
- INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saints Pères, Paris, France
| | - Huyen-Thu Nguyen-Xuan
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
| | - Enrica Bentivegna
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
| | - Anne-Sophie Bats
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
- Faculté de médecine Paris-Descartes, Université Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, CNRS, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Equipe labellisée Ligue Nationale contre le cancer, Paris, France
| | - Henri Azaïs
- Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges-Pompidou, APHP, Paris, France
- Faculté de médecine Paris-Descartes, Université Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, INSERM, CNRS, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, Equipe labellisée Ligue Nationale contre le cancer, Paris, France
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